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Biomedical subjects

A Trott

Publications and source records attributed to A Trott.

At least 19 recordsLinked to original sources
PubMed1996

Premenstrual syndrome: diagnosis and treatment.

Premenstrual syndrome (PMS), many physicians do not believe that the disorder exists. Numerous special interest groups also dispute its existence. There is still no clear consensus about the diagnosis of PMS. It is now a diagnosable disorder which can be effectively treated. This article describes the diagnosis, clinical features, and approach to management of PMS.

Diagnosis, Differential↗
PubMed1995

Ophthalmologic procedures in the emergency department--Part II: Routine evaluation procedures.

The emergency physician (EP) must be familiar with performance of ophthalmologic procedures for evaluation and treatment of a multitude of eye complaints. This article is the second of three articles addressing ophthalmologic procedures potentially of use by the EP. This article reviews the indications and the techniques for the following routine procedures: visual acuity testing, pupil dilatation, topical anesthesia use, and tonometry. Criteria for consultation also are addressed.

Anesthesia, Local↗
PubMed1995

Ophthalmologic procedures in the emergency department--Part III: Slit lamp use and foreign bodies.

The emergency physician (EP) must be familiar with carrying out ophthalmologic procedures for evaluation and treatment of a multitude of eye complaints. This article is the last of three articles addressing ophthalmologic procedures of use by the EP. This article reviews the indications and the techniques for slit lamp examination of the eye and techniques of foreign body removal. Criteria for consultation also are addressed.

Emergency Medicine↗
PubMed1994

Comparison of digital versus metacarpal blocks for repair of finger injuries.

STUDY OBJECTIVE: This study compared efficacy, degree of discomfort, and time to anesthesia of digital blocks and metacarpal blocks for digital anesthesia. DESIGN: Randomized, prospective, nonblinded, clinical study conducted from April 1992 to January 1993. Patients served as their own controls. SETTING: Inner-city and community hospital emergency departments. TYPE OF PARTICIPANTS: Convenience sample of 30 adult patients, with third or fourth finger injuries including and distal to the proximal interphalangeal joint that required digital anesthesia. INTERVENTIONS: Digital blocks and a metacarpal blocks were performed (one per side) on all 30 patients (total of 60 blocks). The order of the blocks was randomized. MEASUREMENTS: A digital block and a metacarpal block were performed on each patient. Patients immediately rated the pain associated with each technique on a nonsegmented visual analog scale. Efficacy was assessed by requirement for additional anesthesia and anesthesia to pinprick. Time to anesthesia was assessed after each block in 23 patients. RESULTS: Mean visual analog scale pain scores were 2.53 for digital block and 3.38 for metacarpal block (P = .1751, Student's t-test). Metacarpal block failed anesthesia to pinprick in 23% of patients compared to 3% for digital block (P = .0227, chi 2). Time to anesthesia was significantly shorter for digital block compared to metacarpal block, with a mean of 2.82 minutes versus 6.35 minutes (P < .0001, Student's t-test). CONCLUSION: Digital block and metacarpal block, as described in this study, are equally painful procedures. Digital block, however, is more efficacious and requires significantly less time to anesthesia for the injured finger.

Adult↗
PubMed1992

Chronic skin ulcers.

Chronic skin ulceration is a common complication of diabetes, peripheral vascular disease, and disorders that decrease mobility. Local ulcer care will be successful only if the underlying cause is correctly identified and steps are taken to reverse it. This article reviews the emergency department assessment and management of the patient with chronic skin ulceration.

Chronic Disease↗
PubMed1988

Mechanisms of surface soft tissue trauma.

Abrasions, lacerations, and burns are common examples of surface soft tissue trauma seen in emergency care facilities. These injuries are the result of a complex set of wounding mechanisms that can be significantly modified by other important wound variables. Mechanisms of surface trauma can be divided into two categories -- mechanical and thermal. Mechanical forces include shearing, tension, and compression. The last produces the greatest degree of tissue trauma and can complicate wound repair and healing. Thermal injuries are mediated through radiation, convection, conduction, electricity, and excessive cold. Factors that can modify the mechanism of injury are the wounding material and biologic variables, including the anatomic site of injury, underlying health status, and current use of medications. A working knowledge of wounding mechanisms and their related clinical considerations can be useful in the selection of wound management techniques and in predicting eventual wound outcome.

Biomechanical Phenomena↗
PubMed1987

Hepatitis B exposure and the emergency physician: risk assessment and hepatitis vaccine update.

Since the hepatitis B vaccine was licensed in 1981, emergency physicians have had the opportunity to be immunized against the hepatitis B virus (HBV). The factors that affect the decision to undergo vaccination include the risk of acquiring an HBV infection in emergency practice, the prevaccination immune status of emergency physicians who have knowledge of their hepatitis serum marker profile, and the efficacy and safety of the vaccine. Emergency physicians have a significant risk of acquiring an HBV infection and are recommended by the Centers for Disease Control to receive vaccination. However, emergency physicians are often incidentally tested for HBV serum markers before immunization. Recent investigations have shown that seropositivity for hepatitis surface antibody (anti-HBs) does not necessarily preclude the need for immunization. Finally, experience with 750,000 doses has shown that it is a highly effective and extremely safe vaccine.

Emergency Medicine↗
PubMed1987

Diagnostic modalities in gynecologic and obstetric emergencies.

Gynecologic emergencies are an integral part of the practice of an emergency physician. In fact, the occurrence of one of these, ectopic pregnancy, has increased dramatically in recent years. Fortunately, the diagnostic modalities available to emergency physicians, particularly serologic pregnancy testing and ultrasonography, have kept pace by undergoing tremendous technologic improvements that allow more rapid and accurate diagnosis of these potential life threats. Armed with the still valuable procedure of culdocentesis as well, the emergency physician has never been in a better position to cope with the distressed gynecological patient.

Douglas' Pouch↗
PubMed1984

The prevalence of hepatitis B serological markers in emergency physicians.

Hepatitis B (HBV) is a well-documented, increasing occupational hazard to those in the medical and dental professions. While the prevalence of markers of hepatitis B in the general population in the United States is approximately 3% to 5%, the prevalence in the health professions has been found to be higher. The prevalence of markers in 260 emergency physicians, consisting of teaching and nonteaching staff and emergency medicine residents, was the focus of this study. Two hundred fourteen participants had not received hepatitis B vaccine; 46 had received the vaccine. Hepatitis B surface antigen (HBsAg), surface antibody (anti-HBs) and core antibody (anti-HBc) were tested. The overall prevalence of markers in the nonvaccinated group was 11.7% (25/214). Forty-one of 46 participants (89%) who had received hepatitis B vaccine demonstrated anti-HBs, evidence of immunity to hepatitis B. Thirty-nine of them had anti-HBs alone, and two had anti-HBs and anti-HBc. Of the five vaccinees who failed to demonstrate anti-HBs, one demonstrated anti-HBc alone. There was no statistically significant difference between the three groups in prevalence or type of markers. The prevalence of hepatitis B serological markers in this survey of emergency physicians was two and a half to four times that of the general population. Because of the increased risk of exposure to hepatitis B virus, early immunization against this disease through the use of hepatitis B vaccine should be considered by physicians in the practice of emergency medicine.

Emergency Medicine↗
PubMed1984

Transcutaneous cardiac pacing.

Transvenous cardiac pacing is currently the pacing procedure of choice in patients with severe, life-threatening bradyarrhythmias that do not respond to pharmacotherapy. However, pacing catheters can be difficult to insert and frequently fail to capture in severely hypotensive patients. Therefore, there has been a recent resurgence of interest in external pacing methods. Newer transcutaneous cardiac pacing units are easy to apply and especially suited for unconscious patients with severe, life-threatening bradyarrhythmias. There is no operator danger and, if need be, cardiopulmonary resuscitation can continue while the electrodes are in place and the unit is operating. Human and animal studies to date have shown that there are no significant short-term clinical hazards or pathologic abnormalities when using this technique.

Bradycardia↗
PubMed1984

Approach to quality assurance in an emergency department: a one-year review.

The Joint Commission on Accreditation of Hospitals requires that an organized quality assurance program be in place for all emergency departments under its review. The authors' institution has had a quality assurance program since 1978. The program is structured to assess medical records against pre-established standards of medical care; to review all radiologic, electrocardiographic and bacteriologic culture reports to avoid discrepancies following initial clinical intervention; and to analyze all emergency department deaths. A review of this program was undertaken for the year 1982 to assess outcome and benefit. Of 74,760 charts reviewed, 744 did not meet the pre-established standards. Seventy-seven patients were asked to return to the emergency department at once. Three hundred fourteen radiographs were initially misread by clinicians and 63 patients were called back for immediate reexamination. Seventy-four electrocardiograms were initially misinterpreted, and 21 patients required urgent call-back. One hundred eighteen patients with positive urine cultures and 35 patients with positive throat cultures were not treated or were incorrectly treated during their initial visit. These patients were notified of the need for additional therapy. There were 158 emergency department deaths, and 11 were thought to have been possibly preventable.

Emergency Service, Hospital↗
PubMed1979

Recurrent upper airway obstruction.

Two case reports document airway reobstruction following the use of hemostats by paramedics (EMT-P) to successfully relieve meat impaction of the hypopharynx. In one, the obstruction was the result of local edema and, in the other, there was incomplete removal of the obstruction.

Aged↗